# Chronic Abdominal Pain and Gastrointestinal Symptoms 12 Years After Primary Roux-en-Y Gastric Bypass: A Cross-Sectional Controlled Study

## TL;DR

This study found that a third of patients who had gastric bypass surgery experienced chronic abdominal pain 12 years later, more than in the general population.

## Contribution

The study provides new insights into the long-term prevalence and characteristics of chronic abdominal pain after Roux-en-Y gastric bypass.

## Key findings

- 32.7% of RYGB patients reported chronic abdominal pain compared to 23.2% of controls.
- Severe chronic pain was reported by 16.5% of RYGB patients versus 10.1% of controls.
- Severe pain after RYGB was more often located in the upper abdomen and associated with nausea.

## Abstract

The knowledge on chronic abdominal pain and gastrointestinal (GI) symptoms as a long-term complication to Roux-en-Y gastric bypass (RYGB) is limited. The aim of this study was to explore the frequency and characteristics of chronic abdominal pain and GI symptoms long-term after primary RYGB compared to the general population.

A cross-sectional study of patients 10–15 years after RYGB compared to a control group with a similar age and sex distribution from the HUNT4 Survey. Abdominal pain and GI symptoms were assessed with a self-reported questionnaire.

A total of 496 patients were included, with a mean observation time of 11.7 ± SD 1.6 years after RYGB. The controls were 3000 participants from HUNT4. Chronic abdominal pain was reported by 162 (32.7%) RYGB patients compared to 697 (23.2%) of the controls (p < 0.001). Bloating was the most common GI symptom reported by 356 (72%) RYGB patients. Eighty-two (16.5%) RYGB patients and 302 (10.1%) controls graded chronic pain as severe (p < 0.001). Severe chronic pain after RYGB was more often located in the upper part of the abdomen in 58 (71%) patients, associated with severe nausea in 27 (33%) patients, and less often relieved after defecation in 35 (42%) patients compared to the controls (p < 0.001).

Twelve years after RYGB, a third of patients reported chronic abdominal pain compared with a quarter of controls. Half of the participants with chronic abdominal pain in both groups rated the pain as severe. The location of severe pain and associations with other gastrointestinal symptoms differed between the two groups.